Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Cancer
Published in: BMC Cancer 1/2012

Open Access 01-12-2012 | Research article

Survival of endometrial cancer patients in Germany in the early 21st century: a period analysis by age, histology, and stage

Authors: Tianhui Chen, Lina Jansen, Adam Gondos, Meike Ressing, Bernd Holleczek, Alexander Katalinic, Hermann Brenner, The GEKID Cancer Survival Working Group

Published in: BMC Cancer | Issue 1/2012

Login to get access

Abstract

Background

Population-based studies on endometrial cancer providing survival estimates by age, histology, and stage have been sparse. We aimed to derive most up-to-date and detailed survival estimates for endometrial cancer patients in Germany.

Methods

We used a pooled German national dataset including data from 11 cancer registries covering a population of 33 million people. 30,906 patients diagnosed with endometrial cancer in 1997-2006 were included. Period analysis was performed to calculate 5-year relative survival (RS) in 2002-2006. Trends in survival between 2002 and 2006 were examined using model-based period analysis. Age-adjustment was performed using five age groups (15-44, 45-54, 55-64, 65-74, and 75+ years).

Results

Overall, age-adjusted 5-year relative survival in 2002-2006 was 81%. A moderate age gradient was observed, with 5-year RS decreasing from 90% in the age group 15-49 years to 75% in the age group 70+ years. Furthermore prognosis varied strongly by histologic subtypes and stage, with age-adjusted 5-year RS ranging from 43% (for sarcoma) to 94% (for squamous metaplasia), and reaching 91% for localized, 51% for regional, and 20% for distant stage. Except for age group 65-74 years, no significant improvement in survival was seen during the recent 5-year period under investigation.

Conclusion

In this comprehensive population-based survival analysis of patients with endometrial cancer from Germany, prognosis of endometrial cancer moderately varied by age, and strongly varied by histology and stage. While prognosis is rather good overall, further improvement in 5-year relative survival of endometrial cancer patients has been stagnating in the early 21st century.
Literature
1.
Ferlay J, Shin HR, Bray F, et al: Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer. 2010, 127: 2893-917. 10.1002/ijc.25516.CrossRefPubMed
2.
Ferlay J, Shin HR, Bray F, et al: GLOBOCAN 2008, Cancer Incidence and Mortality Worldwide. Lyon, France: International Agency for Research on Cancer: IARC CancerBase No. 10. 2010
3.
Averette HE, Steren A, Nguyen HN: Screening in gynecologic cancers. Cancer. 1993, 72 (3 Suppl): 1043-9.CrossRefPubMed
4.
Bray F, Dos Santos Silva I, Moller H, Weiderpass E: Endometrial cancer incidence trends in Europe: underlying determinants and prospects for prevention. Cancer Epidemiol Biomarkers Prev. 2005, 14: 1132-42. 10.1158/1055-9965.EPI-04-0871.CrossRefPubMed
5.
Kaaks R, Lukanova A, Kurzer MS: Obesity, endogenous hormones, and endometrial cancer risk: a synthetic review. Cancer Epidemiol Biomarkers Prev. 2002, 11: 1531-43.PubMed
6.
Sant M, Allemani C, Santaquilani M, et al: EUROCARE-4. Survival of cancer patients diagnosed in 1995-1999. Results and commentary. Eur J Cancer. 2009, 45: 931-91. 10.1016/j.ejca.2008.11.018.CrossRefPubMed
7.
Brenner H, Gondos A, Arndt V: Recent major progress in long-term cancer patient survival disclosed by modeled period analysis. J Clin Oncol. 2007, 25: 3274-80. 10.1200/JCO.2007.11.3431.CrossRefPubMed
8.
Kosary CL, Cancer of the corpus uteri, et al: SEER Survival Monograph: Cancer Survival Among Adults: U.S. SEER Program, 1988-2001, Patient and Tumor Characteristics. Edited by: Gloeckler RLA, Young JL, Keel GE. 2007, Bethesda, MD: National Cancer Institute, SEER Program, NIH Pub, 123-32.
9.
Gloeckler RLA, Reichman ME, Lewis DR, Hankey BF, Edwards BK: Cancer survival and incidence from the Surveillance, Epidemiology, and End Results (SEER) program. Oncologist. 2003, 8: 541-52. 10.1634/theoncologist.8-6-541.CrossRef
10.
Hamilton CA, Cheung MK, Osann K, et al: Uterine papillary serous and clear cell carcinomas predict for poorer survival compared to grade 3 endometrioid corpus cancers. Br J Cancer. 2006, 94: 642-6.PubMedPubMedCentral
11.
Brenner H, Stegmaier C, Ziegler H: Long-term survival of cancer patients in Germany achieved by the beginning of the third millenium. Ann Oncol. 2005, 16: 981-6. 10.1093/annonc/mdi186.CrossRefPubMed
12.
Brenner H, Gefeller O: An alternative approach to monitoring cancer patient survival. Cancer. 1996, 78: 2004-10. 10.1002/(SICI)1097-0142(19961101)78:9<2004::AID-CNCR23>3.0.CO;2-#.CrossRefPubMed
13.
Brenner H, Gefeller O, Hakulinen T: Period analysis for 'up-to-date' cancer survival data: theory, empirical evaluation, computational realisation and applications. Eur J Cancer. 2004, 40: 326-35. 10.1016/j.ejca.2003.10.013.CrossRefPubMed
14.
Brenner H, Hakulinen T: Up-to-date and precise estimates of cancer patient survival: model-based period analysis. Am J Epidemiol. 2006, 164: 689-96. 10.1093/aje/kwj243.CrossRefPubMed
15.
Gondos A, Bray F, Brewster DH, et al: Recent trends in cancer survival across Europe between 2000 and 2004: a model-based period analysis from 12 cancer registries. Eur J Cancer. 2008, 44: 1463-75. 10.1016/j.ejca.2008.03.010.CrossRefPubMed
16.
Hiripi E, Gondos A, Emrich K, et al: Survival from common and rare cancers in Germany in the early 21st century. Ann Oncol 201. 2012, 23: 472-9. 10.1093/annonc/mdr131.CrossRef
17.
Fritz A, Percy C, Jack A, et al: International Classification of Diseases for Oncology. 2000, Geneva: World Health Organization, 3
18.
Berrino F, Brown C, Moeller T: Sobin L. 2002, ENCR Recommendations: Condensed TNM for Coding the Extent of Disease
19.
Brenner H, Soderman B, Hakulinen T: Use of period analysis for providing more up-to-date estimates of long-term survival rates: empirical evaluation among 370,000 cancer patients in Finland. Int J Epidemiol. 2002, 31: 456-62. 10.1093/ije/31.2.456.CrossRefPubMed
20.
Brenner H, Hakulinen T: Up-to-date long-term survival curves of patients with cancer by period analysis. J Clin Oncol. 2002, 20: 826-32. 10.1200/JCO.20.3.826.CrossRefPubMed
21.
Ederer F, Axtell LM, Cutler SJ: The relative survival rate: a statistical methodology. Natl Cancer Inst Monogr. 1961, 6: 101-21.PubMed
22.
Ederer F, Heise H: Instructions to IBM 650 programmers in processing survival computations. 1959, Bethesda (MD): National Cancer Institute
23.
Perme MP, Stare J, Estève J: On Estimation in Relative Survival. Biometrics. doi: 10.1111/j.1541-0420.2011.01640.x,
24.
Corazziari I, Quinn M, Capocaccia R: Standard cancer patient population for age standardising survival ratios. Eur J Cancer. 2004, 40: 2307-16. 10.1016/j.ejca.2004.07.002.CrossRefPubMed
25.
Brenner H, Gefeller O, Hakulinen T: A computer program for period analysis of cancer patient survival. Eur J Cancer. 2002, 38: 690-5. 10.1016/S0959-8049(02)00003-5.CrossRefPubMed
26.
Verdecchia A, Francisci S, Brenner H, et al: Recent cancer survival in Europe: a 2000-02 period analysis of EUROCARE-4 data. Lancet Oncol. 2007, 8: 784-96. 10.1016/S1470-2045(07)70246-2.CrossRefPubMed
27.
Klint A, Tryggvadottir L, Bray F, et al: Trends in the survival of patients diagnosed with cancer in female genital organs in the Nordic countries 1964-2003 followed up to the end of 2006. Acta Oncol. 2010, 49: 632-43. 10.3109/02841861003691945.CrossRefPubMed
28.
Verdecchia A, Guzzinati S, Francisci S, et al: Survival trends in European cancer patients diagnosed from 1988 to 1999. Eur J Cancer. 2009, 45: 1042-66. 10.1016/j.ejca.2008.11.029.CrossRefPubMed
29.
Gatta G, Lasota MB, Verdecchia A: Survival of European women with gynaecological tumours, during the period 1978-1989. EUROCARE Working Group. Eur J Cancer. 1998, 34: 2218-25. 10.1016/S0959-8049(98)00326-8.CrossRefPubMed
30.
Levi F, Randimbison L, La Vecchia C: Trends in endometrial cancer incidence and survival in the Swiss Canton of Vaud. Br J Cancer. 1992, 66: 720-2. 10.1038/bjc.1992.345.CrossRefPubMedPubMedCentral
31.
Osmers RG, Osmers M, Kuhn W: Prognostic value of transvaginal sonography in asymptomatic endometrial cancers. Ultrasound Obstet Gynecol. 1995, 6: 103-7. 10.1046/j.1469-0705.1995.06020103.x.CrossRefPubMed
32.
Smith RA, von Eschenbach AC, Wender R, et al: American Cancer Society guidelines for the early detection of cancer: update of early detection guidelines for prostate, colorectal, and endometrial cancers. Also: update 2001-testing for early lung cancer detection. CA Cancer J Clin. 2001, 51: 38-75. 10.3322/canjclin.51.1.38.CrossRefPubMed
33.
Smith RA, Cokkinides V, Brooks D, et al: Cancer screening in the United States, 2011: A review of current American Cancer Society guidelines and issues in cancer screening. CA Cancer J Clin. 2011, 61: 8-30. 10.3322/caac.20096.CrossRefPubMed
34.
Fleischer AC, Wheeler JE, Lindsay I, et al: An assessment of the value of ultrasonographic screening for endometrial disease in postmenopausal women without symptoms. Am J Obstet Gynecol. 2001, 184: 70-5. 10.1067/mob.2001.111088.CrossRefPubMed
35.
Jacobs I, Gentry-Maharaj A, Burnell M, et al: Sensitivity of transvaginal ultrasound screening for endometrial cancer in postmenopausal women: a case-control study within the UKCTOCS cohort. Lancet Oncol. 2011, 12: 38-48. 10.1016/S1470-2045(10)70268-0.CrossRefPubMed
36.
Lin JF, Slomovitz BM: Uterine sarcoma 2008. Curr Oncol Rep. 2008, 10: 512-8. 10.1007/s11912-008-0077-9.CrossRefPubMed
37.
Bansal N, Herzog TJ, Burke W, Cohen CJ, Wright JD: The utility of preoperative endometrial sampling for the detection of uterine sarcomas. Gynecol Oncol. 2008, 110: 43-8. 10.1016/j.ygyno.2008.02.026.CrossRefPubMed
38.
Gadducci A: Prognostic factors in uterine sarcoma. Best Pract Res Clin Obstet Gynaecol. 2011,
39.
Ueda SM, Kapp DS, Cheung MK, et al: Trends in demographic and clinical characteristics in women diagnosed with corpus cancer and their potential impact on the increasing number of deaths. Am J Obstet Gynecol. 2008, 198: 218-6.CrossRefPubMed
40.
Quaglia A, Tavilla A, Shack L, et al: The cancer survival gap between elderly and middle-aged patients in Europe is widening. Eur J Cancer. 2009, 45: 1006-16. 10.1016/j.ejca.2008.11.028.CrossRefPubMed
41.
Gondos A, Holleczek B, Arndt V, et al: Trends in population-based cancer survival in Germany: to what extent does progress reach older patients?. Ann Oncol. 2007, 18: 1253-9. 10.1093/annonc/mdm126.CrossRefPubMed
42.
Kosary CL: FIGO stage, histology, histologic grade, age and race as prognostic factors in determining survival for cancers of the female gynecological system: an analysis of 1973-87 SEER cases of cancers of the endometrium, cervix, ovary, vulva, and vagina. Semin Surg Oncol. 1994, 10: 31-46. 10.1002/ssu.2980100107.CrossRefPubMed
43.
Balducci L: Geriatric oncology: challenges for the new century. Eur J Cancer. 2000, 36: 1741-54. 10.1016/S0959-8049(00)00169-6.CrossRefPubMed
44.
Nordal RR, Thoresen SO: Uterine sarcomas in Norway 1956-1992: incidence, survival and mortality. Eur J Cancer. 1997, 33: 907-11. 10.1016/S0959-8049(97)00040-3.CrossRefPubMed
45.
Akhmedkhanov A, Zeleniuch-Jacquotte A, Toniolo P: Role of exogenous and endogenous hormones in endometrial cancer: review of the evidence and research perspectives. Ann N Y Acad Sci. 2001, 943: 296-315.CrossRefPubMed
46.
Allen NE, Key TJ, Dossus L, et al: Endogenous sex hormones and endometrial cancer risk in women in the European Prospective Investigation into Cancer and Nutrition (EPIC). Endocr Relat Cancer. 2008, 15: 485-97. 10.1677/ERC-07-0064.CrossRefPubMedPubMedCentral
47.
Mylonas I, Jeschke U, Shabani N, et al: Steroid receptors ERalpha, ERbeta, PR-A and PR-B are differentially expressed in normal and atrophic human endometrium. Histol Histopathol. 2007, 22: 169-76.PubMed
48.
Snijders MP, de Goeij AF, Debets-Te Baerts MJ, et al: Immunocytochemical analysis of oestrogen receptors and progesterone receptors in the human uterus throughout the menstrual cycle and after the menopause. J Reprod Fertil. 1992, 94: 363-71. 10.1530/jrf.0.0940363.CrossRefPubMed
49.
Shabani N, Kuhn C, Kunze S, et al: Prognostic significance of oestrogen receptor alpha (ERalpha) and beta (ERbeta), progesterone receptor A (PR-A) and B (PR-B) in endometrial carcinomas. Eur J Cancer. 2007, 43: 2434-44. 10.1016/j.ejca.2007.08.014.CrossRefPubMed
50.
Jongen V, Briët J, de Jong R, et al: Expression of estrogen receptor-alpha and -beta and progesterone receptor-A and -B in a large cohort of patients with endometrioid endometrial cancer. Gynecol Oncol. 2009, 112: 537-42. 10.1016/j.ygyno.2008.10.032.CrossRefPubMed
51.
Miyamoto T, Watanabe J, Hata H, et al: Significance of progesterone receptor-A and -B expressions in endometrial adenocarcinoma. J Steroid Biochem Mol Biol. 2004, 92: 111-8. 10.1016/j.jsbmb.2004.07.007.CrossRefPubMed
52.
Mylonas I: Prognostic significance and clinical importance of estrogen receptor alpha and beta in human endometrioid adenocarcinomas. Oncol Rep. 2010, 24: 385-93.CrossRefPubMed
53.
Sehouli J, Koensgen D, Oskay-Ozcelik G, Mustea A: New aspects of adjuvant therapy in endometrial cancer: current standards and future directions. Crit Rev Oncol Hematol. 2008, 67: 204-12. 10.1016/j.critrevonc.2008.02.011.CrossRefPubMed
54.
Osmers R, Volksen M, Schauer A: Vaginosonography for early detection of endometrial carcinoma?. Lancet. 1990, 335: 1569-71. 10.1016/0140-6736(90)91387-P.CrossRefPubMed
55.
Tangjitgamol S, Anderson BO, See HT, et al: Management of endometrial cancer in Asia: consensus statement from the Asian Oncology Summit 2009. Lancet Oncol. 2009, 10: 1119-27. 10.1016/S1470-2045(09)70290-6.CrossRefPubMed
56.
Chan JK, Sherman AE, Kapp DS, et al: Influence of gynecologic oncologists on the survival of patients with endometrial cancer. J Clin Oncol. 2011, 29: 832-8. 10.1200/JCO.2010.31.2124.CrossRefPubMed
57.
Roland PY, Kelly FJ, Kulwicki CY, et al: The benefits of a gynecologic oncologist: a pattern of care study for endometrial cancer treatment. Gynecol Oncol. 2004, 93: 125-30. 10.1016/j.ygyno.2003.12.018.CrossRefPubMed
Metadata
Title
Survival of endometrial cancer patients in Germany in the early 21st century: a period analysis by age, histology, and stage
Authors
Tianhui Chen
Lina Jansen
Adam Gondos
Meike Ressing
Bernd Holleczek
Alexander Katalinic
Hermann Brenner
The GEKID Cancer Survival Working Group
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2012
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/1471-2407-12-128

Other articles of this Issue 1/2012

BMC Cancer 1/2012 Go to the issue

Debate

Natural resistance to cancers: a Darwinian hypothesis to explain Peto’s paradox

Research article

Vincristine enhances amoeboid-like motility via GEF-H1/RhoA/ROCK/Myosin light chain signaling in MKN45 cells

Research article

Expression of aurora kinase A is associated with metastasis-free survival in node-negative breast cancer patients

Research article

Androgenic suppression combined with radiotherapy for the treatment of prostate adenocarcinoma: a systematic review

Research article

Systematic review: conservative treatments for secondary lymphedema

Research article

Overcoming Bcr-Abl T315I mutation by combination of GNF-2 and ATP competitors in an Abl-independent mechanism
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits